Qu et al identified prognostic factors for a patient with hepatocellular carcinoma. This can help to identify a patient who may benefit from more aggressive or novel therapy. The authors are from Peking Union Medical College Hospital in Beijing.
Patient selection: hepatocellular carcinoma
Parameters:
(1) distant metastases
(2) tumor size
(3) portal vein tumor thrombosis (PVTT)
(4) serum AFP in ng/mL
(5) paraneoplastic syndrome
(6) Child-Pugh grade
(7) tumor resection
Parameter
Finding
Points
distant metastases
absent
0
present
1
tumor size
< 5 cm
0
>= 5 cm
1
PVTT
absent
0
present
1
serum AFP
< 10,000 ng/mL
0
>= 10,000 ng/mL
1
paraneoplastic syndrome
absent
0
present
1
Child Pugh grade
A
0
B or C
1
resection
no
0
yes
-1
where:
• The concentration of serum AFP seems high and there may be an issue with the units.
• The hazard ratio was 6 for distant metastases. The others ranged from 1.6 to 3.0.
number of poor prognostic factors =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -1
• maximum score: 6
• The higher the score the worse the prognosis.
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